Patient Instructions

Patient Instructions #

Miscarriage #

  1. Place 800mcg of Misoprostol (four 200mcg tabs) in the vagina at bedtime.
  2. Take 800mg of ibuprofen (four 200mg tablets) by mouth at the same time. This will help with cramping and pain.
  3. Repeat steps 1 and 2 the next night.
  • What to expect:
    • Vaginal bleeding and cramping typically begin within a few hours of starting the medication, but can take up to 24-48 hours
    • Most women have no side effects with this medicine, however, some women can have nausea, diarrhea and/or a mild fever
      • Diarrhea is the most reported side effect
      • Fever (>100.4F) should subside within 24 hours
    • Bleeding will peak with the passage of tissue and can last 7-10 days or longer. Bleeding should gradually decrease after the peak.
    • When to call the clinic:
      • Severe and/or persistent abdominal pain
      • If your bleeding is extremely heavy and you are soaking a large pad every 30-60 minutes for three hours with no signs of the bleeding slowing down
      • Bleeding persisting for more than two weeks
        • Its ok to monitor if it’s still decreasing, but please call the office to let us know that it is still continuing
      • Persistent dizziness and/or lightheadedness
      • If you have minimal or no response to the medication within 48 hours of using

Metformin Initiation #

Start taking Metformin. This medicine helps you body better use the insulin that it already makes. It will cause some stomach upset and diarrhea when you start. But, this WILL go away as your body gets used to the medicine. We will slowly start the medicine to help minimize this.

  • Start with 500mg (1 tab) at night, for one week.
  • Next take 500mg (1 tab) in the morning and 500mg (1 tab) at night, for one week.
  • Next take 1000mg (2 tab) in the morning and 500mg (1 tab) at night for one week.
  • Finally, take 1000mg (2 tabs) in the morning and at night thereafter.

Empiece a tomar metformina. Este medicamento le ayuda a su cuerpo a utilizar mejor la insulina que ya produce. Causará malestar estomacal y diarrea cuando empiece. Pero esto desaparecerá a medida que su cuerpo se acostumbre al medicamento. Comenzaremos lentamente el medicamento para minimizar esto.

  • Empiece con 500 mg (1 pestaña) por la noche, durante una semana.
  • A continuación, tome 500 mg (1 pestaña) por la mañana y 500 mg (1 pestaña) por la noche, durante una semana.
  • A continuación, tome 1000 mg (2 pestañas) por la mañana y 500 mg (1 pestaña) por la noche durante una semana.
  • Finalmente, tome 1000 mg (2 tabletas) por la mañana y luego por la noche.